Forgotten DJ Stent with a Large Calculus at Its Distal End in an Ileal Conduit Diversion

Puri, Anurag; Priyadarshi, Vinod; Raizada, Nivedita; Pal, Dilip Kumar

doi:10.1155/2014/684651

Cited by 3 publications

(2 citation statements)

References 6 publications

(16 reference statements)

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“…In another case report, bilateral staghorn calculus was developed due to forgotten DJ stent in a patient with ileal conduit diversion 6 years back [14]. Similarly, Puri et al reported a large calculus encrusted over a forgotten DJ stent in an ileal conduit patient with urinary diversion 8 years earlier [15].…”

Section: Discussionmentioning

confidence: 94%

Forgotten ureteral double-J stents and related complications: a real-world experience

et al. 2020

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Background: Double-J (DJ) stents are among the basic and commonly used tools in urology. The DJ stent generally needs to be replaced or removed within 6 weeks to 6 months to avoid complications like encrustations, stone formation, fractures and blockades of stents. However, in many cases the stent is forgotten. In this retrospective study, we report our experience in the management of forgotten stents and steps taken by us in preventing DJ stent-related morbidity. Results: Of the total of 30 patients, 80% (n = 24) underwent previous procedures in other hospitals and the remaining 20% (n = 6) were from our hospital. The mean age of the patients was 56.66 years. The mean duration of the indwelling stent in situ was 13.83 months. The indications of indwelling stents included ureteroscopic lithotripsy, extracorporeal shock wave lithotripsy and percutaneous nephrolithotomy. Presenting complaints for which patients visited hospital were flank pain (n = 10; 33.33%), dysuria (n = 9; 30%), hematuria (n = 3, 10%) and fever (n = 2; 6.66%). Conclusion: Forgotten DJ stents can be a source of severe morbidity. Patients' and relatives' educational level and counseling before and after the procedure may play a significant role in reducing stent-related complications.

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Section: Discussionmentioning

confidence: 94%

Forgotten ureteral double-J stents and related complications: a real-world experience

et al. 2020

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“…14 16,17 In a case report by Gupta et al, and another by Puri et al, large calculus was developed due to forgotten DJ stent in a patient with ileal conduit diversion. 18,19 Treatment of forgotten DJ stent was indivisualized according to severity of symptoms and radiological findings. In our study, endourological procedure was mostly performed for stent extraction.…”

Section: Discussionmentioning

confidence: 99%

Our experience of forgotten double-J stents in a tertiary care center

Ahsan Ahmad,

Md. Zaid Imbisat,

Rakesh K Anand

2023

Asian J Med Sci

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Background: Double-J (DJ) stents have become an essential tool in the field of urology. Forgotten DJ stents are associated with significant morbidity and mortality, if not intervened timely. Aims and Objectives: In this study, we report our experience of forgotten stents related complications, along with its management and steps taken by us in preventing stent-related morbidity. Materials and Methods: We retrospectively analyzed the records of patients presented to the Department of Urology, Indira Gandhi Institute of Medical Sciences, Patna with forgotten or long-term retention of DJ stents from January 2021 to December 2022. All cases were reviewed for age, gender, symptoms, indication of stent insertion, duration of stent insertion, radiological images, and procedures performed for management. Results: The mean age of the patients was 49.23 years. The mean duration of the indwelling stent in situ was 16.61 months. Presenting complaint was flank pain, recurrent urinary tract infection, dysuria, hematuria, and irritative lower urinary tract symptoms. Common indications of indwelling stents were ureteroscopic lithotripsy, percutaneous nephrolithotomy, and Laparoscopic pyeloplasty. Cystoscopy, ureteroscopy, cystolithotripsy, percutaneous nephrolithotomy, and open surgery were done to extract the forgotten DJ stent. Conclusion: Forgotten DJ stents are a source of severe morbidity. Patients and relatives counseling before and after the procedure is necessary in reducing stent-related complications.

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Bilateral Staghorn Calculus with Forgotten Double J Stent in Ileal Conduit Patient – A Rare Urological Challenge

Gupta

Dey

Sharma

et al. 2017

JCDR

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A 32-year-old male patient presented to the hospital with the complaints of intermittent dull aching left flank pain for last four months. There was history of passage of tube like structure (lower end of right DJ stent) through ileal conduit 15 days back. He had undergone radical cystectomy with ileal conduit for muscle invasive bladder tumor six years back in another hospital. Later, he did not follow up for timely removal of stents. In mean time, he was asymptomatic. His ileal conduit was draining well and there was no history of any major illness, haematuria, fever or graveluria. Clinical examination was essentially normal, showing a well-functioning ileal conduit and a healthy previous surgical scar.Urine for routine analysis revealed alkaline pH (7.8), amorphous phosphate and triple phosphate crystals. Urine culture was positive for Escherichia coli and sensitive to amikacin, levofloxacin, cefoperazone, cefuroxime, meropenem and imipenem. His haemoglobin was 11.2 g/dl and total leucocyte count was 10800 µ/L. Serum urea and creatinine was 74 mg/dl and 2.9 mg/dl respectively. X-ray Kidney, Ureter and Bladder (KUB) revealed bilateral staghorn calculus. Additionally, a fragment of DJ stent of about 3 cm was seen in right sided kidney and complete DJ stent on left sided was seen from left kidney to ileal conduit . Contrast study could not be performed due to high creatinine level, so plain CT with 3D reconstruction was advised. NCCT KUB confirmed the x-ray findings .Patient was planned for bilateral PCNL first on right side than on left side in different sittings and ESWL for residual stones. IV cefoperazone was given in perioperative period. Retrograde pyelography was not possible due to inaccessible ureteral anastomotic orifices. For right sided PCNL patient was turned in prone position, care of pressure points was taken. Initial stone puncture was done with 21-gauge initial puncture needle. After confirming the tip of needle inside the system by aspirating the urine, 76% urograffin contrast was given to opacified the pelvicalyceal system. Then puncture was done in upper and lower calyces on right side and guidewire passed down in ureter, then both tracts were serially dilated to pass 30Fr amplatz sheath.The stone was then fragmented with pneumatic lithoclast (Lithoclast Master Electro-Medical Systems, Nyon, Switzerland). DJ fragment and stone fragments were endoscopically extracted with nontraumatic grasper. About 80-90% of stone burden was removed in a single sitting. Nephrostomy tube was given though lower tract and taken out after five days [ Forgotten DJ stent associated stone formation is not an uncommon entity. Here we are reporting the uncommon case of bilateral staghorn calculus due to forgotten DJ stent who had undergone radical cystectomy with ileal conduit diversion six years back. Management of these cases is a challenging urological situation due to inaccessible ureteric orifices. Patient was successfully treated with minimally invasive therapy in the form of combined bilateral PCNL (Percutaneou...

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Forgotten DJ Stent with a Large Calculus at Its Distal End in an Ileal Conduit Diversion

Cited by 3 publications

References 6 publications

Forgotten ureteral double-J stents and related complications: a real-world experience

Forgotten ureteral double-J stents and related complications: a real-world experience

Our experience of forgotten double-J stents in a tertiary care center

Bilateral Staghorn Calculus with Forgotten Double J Stent in Ileal Conduit Patient – A Rare Urological Challenge

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